HIV: low prevalence is no excuse for not testing

Abstract

There are currently an estimated 86 500 individuals living with HIV infection in the UK, one-quarter of whom are unaware of their infection.1 Of the 6630 adults newly diagnosed in 2009, 52% had a CD4 count less than 350 × 106/L at the time of diagnosis, the recommended threshold at which antiretroviral therapy should be commenced.1 Thirty per cent were diagnosed with a CD4 count less than 200 × 106/L, which is indicative of severe immune deficiency and associated with a significantly higher risk of death in the first 3 months.1 Earlier diagnosis allows more timely initiation of therapy and is associated with a higher estimated life expectancy than for individuals started on treatment in late disease. Approximately one-quarter of all deaths in HIV-positive people are attributable to late diagnosis.2 Furthermore, earlier diagnosis has potential benefits to the wider public health. Knowledge of HIV infection is associated with behaviour change to reduce the risk of onward transmission.3 In addition, effective antiretroviral therapy substantially reduces the infectiousness …